PART VIII Antidepressant agents
01. The principal mechanism of action of antidepressant agents is:
a) Stabilization of dopamine and beta-adrenergic receptors
b) Inhibition of the storage of serotonin and epinephrine in the vesicles of presynaptic nerve endings
c) Blocking epinephrine or serotonin reuptake pumps
d) Stimulation of alfa2-norepinephrine receptors
02. Which of the following agents is related to tricyclic antidepressants?
a) Nefazodon
b) Amitriptyline
c) Fluoxetine
d) Isocarboxazid
03. Indicate the second-generation heterocyclic drug:
a) Maprotiline
b) Imipramine
c) Phenelzine
d) Fluoxetine
04. Which of the following agents is related to the third-generation heterocyclic antidepressants?
a) Amitriptyline
b) Maprotiline
c) Nefazodone
d) Tranylcypromine
05. Which of the following antidepressants is a selective serotonin reuptake inhibitor?
a) Phenelzine
b) Desipramine
c) Maprotiline
d) Fluoxetine
06. Which of the following antidepressant agents is a selective inhibitor of norepinephrine reuptake?
a) Fluvoxamine
b) Maprotiline
c) Amitriptyline
d) Tranylcypromine
07. Indicate the antidepressant, which blocks the reuptake pumps for serotonin and norepinephrine:
a) Amitriptyline
b) Fluoxetine
c) Maprotiline
d) Phenelzine
08. Which of the following antidepressants is an unselective MAO blocker and produces extremely long-lasting inhibition of the enzyme?
a) Moclobemide
b) Tranylcypramine
c) Selegiline
d) Fluoxetine
09. Indicate the irreversible MAO inhibitor, which is a hydrazide derivative:
a) Moclobemide
b) Selegiline
c) Tranylcypramine
d) Phenelzine
10. Which of the following MAO inhibitors has amphetamine-like activity and is related to nonhydrazide derivatives:
a) Phenelzine
b) Moclobemide
c) Tranylcypramine
d) All of the above
11. Which of the following antidepressants is a selective short-acting MAO-A inhibitor?
a) Maprotiline
b) Amitriptyline
c) Moclobemide
d) Selegiline
12. Monoamine Oxydase A:
a) Is responsible for norepinephrine, serotonin, and tyramine metabolism
b) Is more selective for dopamine
c) Metabolizes norepinephrine and dopamine
d) Deaminates dopamine and serotonin
13. Which synapses are involved in depression?
a) Dopaminergic synapses
b) Serotoninergic synapses
c) Cholinergic synapses
d) All of the above
14. Block of which type of Monoamine Oxydase might be more selective for depression?
a) MAO-A
b) MAO-B
c) Both MAO-A and MAO-B
d) MAO-C
15. The principal mechanism of MAO inhibitor action is:
a) Blocking the amine reuptake pumps, which permits to increase the concentration of the neurotransmitter at the receptor site
b) Blocking a major degradative pathway for the amine neurotransmitters, which permits more amines to accumulate in presynaptic stores
c) Inhibition the storage of amine neurotransmitters in the vesicles of presynaptic nerve endings
d) Antagonism of alfa2-norepinephrine receptors
16. The irreversible MAO inhibitors have a very high risk of developing:
a) Respiratory depression
b) Cardiovascular collapse and CNS depression
c) Hypertensive reactions to tyramine ingested in food
d) Potentially fatal agranulocytosis
17. The most dangerous pharmacodynamic interaction is between MAO inhibitors and:
a) Selective serotonin reuptake inhibitors
b) Tricyclics
c) Sympathomimetics
d) All of the above
18. Serotonin syndrome is a result of:
a) Increased stores of monoamine
b) Significant accumulation of amine neurotransmitters in the synapses
c) Both a and b
d) Depleted stores of biogenic amines
19. The therapeutic response to antidepressant drugs is usually over a period of:
a) 2-3 days
b) 2-3 weeks
c) 24 hours
d) 2-3 month
20. Which of the following antidepressants may have latency period as short as 48 hours?
a) Tranylcypromine
b) Imipramine
c) Fluoxetine
d) Amitrityline
21. Which of the following features do MAO inhibitors and tricyclic antidepressants have in common?
a) Act postsynaptically to produce their effect
b) Can precipitate hypotensive crises if certain foods are ingested
c) Increase levels of biogenic amines
d) Are useful for the manic phase of bipolar disorder
22. Tricyclic antidepressants are:
a) Highly selective serotonin reuptake inhibitors
b) Monoamine oxidase inhibitors
c) Selective norepinephrine reuptake inhibitors
d) Mixed norepinephrine and serotonin reuptake inhibitors
23. Which of the following autonomic nervous system effects is common for tricyclic antidepressants?
a) Antimuscarinic action
b) Antihistaminic action
c) Alfa adrenoreceptor-blocking action
d) All of the above
24. Indicate an effective antidepressant with minimal autonomic toxicity:
a) Amitrityline
b) Fluoxetine
c) Imipramine
d) Doxepin
25. Fluoxetine has fewer adverse effects because of:
a) Mixed norepinephrine and serotonin reuptake inhibition
b) Depleted stores of amine neurotransmitters
c) Minimal binding to cholinergic, histaminic, and alfa-adrenergic receptors
d) All of the above
26. Which of the following tricyclic and heterocyclic antidepressants has the greatest sedation?
a) Doxepin
b) Amitriptyline
c) Trazodone
d) All of the above
27. Which of the following tricyclic and heterocyclic agents has the least sedation?
a) Protriptyline
b) Trazodone
c) Amitriptyline
d) Mitrazapine
28. Indicate a tricyclic or a heterocyclic antidepressant having greatest antimuscarinic effects:
a) Desipramine
b) Amitriptyline
c) Trazodone
d) Mirtazapine
29. Indicate a tricyclic or a heterocyclic antidepressant having least antimuscarinic effects:
a) Trazodone
b) Buprorion
c) Mirtazapine
d) All of the above
30. Which of the following antidepressants has significant alfa2-adrenoreceptor antagonism?
a) Amitriptyline
b) Nefazodone
c) Mirtazapine
d) Doxepin
31. Indicate the main claim for an ideal antidepressant agent:
a) A faster onset of action
b) Fewer adverse sedative and autonomic effects
c) Fewer toxicity when overdoses are taken
d) All of the above
32. Sedation, peripheral atropine-like toxicity (e.g. Cycloplegia, tachycardia, urinary retention, and constipation), orthostatic hypotension, arrhythmias, weight gain and sexual disturbances are possible adverse effects of:
a) Sertaline
b) Amitriptyline
c) Phenelsine
d) Bupropion
33. Which of the following drugs is least likely to be prescribed to patients with prostatic hypertrophy, glaucoma, coronary and cerebrovascular disease?
a) Amitriptyline
b) Paroxetine
c) Bupropion
d) Fluoxetine
34. Indicate the antidepressant agent, which is a phenyltolylpropylamine derivative:
a) Paroxetine
b) Maprotiline
c) Fluoxetine
d) Amitriptyline
35. The mechanism of fluoxetine action includes:
a) Selective inhibition of serotonine uptake in the CNS
b) Little effect on central norepinephrine or dopamine function
c) Minimal binding to cholinergic, histaminic, and alfa-adrenergic receptors
d) All of the above
36. Which of the following antidepressants is used for treatment of eating disorders, especially buliemia?
a) Amitriptyline
b) Fluoxetine
c) Imipramine
d) Tranylcypromine
37. Sertaline and paroxetine are similar to fluoxetine in the mechanism of action and therapeutic use, sertaline is less likely to interact adversely with other drugs.
a) True
b) False
38. A highly selective serotonine reuptake inhibitor is:
a) Sertaline
b) Paroxetine
c) Fluoxetine
d) All of the above
